<p>Pregnant women are at heightened risk for severe outcomes from infectious diseases like COVID-19, yet were not included in initial vaccine trials, which may contribute to low booster uptake (15% or lower). We explored the serological and cellular responses to COVID-19 mRNA booster vaccines (i.e., ancestral and BA.5) in pregnant and age-matched, non-pregnant females to identify how pregnancy affects immunity against the vaccine and novel variants. Antibodies from pregnant women were less cross-reactive to non-vaccine antigens, including XBB.1.5 and JN.1. Non-pregnant females showed greater IgG1:IgG3 ratios and neutralization against all variants. In contrast, pregnant women had lower IgG1:IgG3 ratios and neutralization but increased antibody-dependent NK cell cytokine production and neutrophil phagocytosis, especially against novel variants. Pregnancy increased memory CD4+ T cells, IFNγ production, monofunctional dominance, and fatty acid oxidation. Pregnancy may reduce the breadth, composition, and magnitude of humoral and cellular immunity, particularly in response to novel variants.</p><p></p>

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Pregnancy reduces COVID-19 vaccine immunity against novel variants

  • Maclaine A. Parish,
  • Jaiprasath Sachithanandham,
  • Lizeth Gutierrez,
  • Han-Sol Park,
  • Anna Yin,
  • Katerina Roznik,
  • Patrick Creisher,
  • John S. Lee,
  • Laura A. St Clair,
  • Annie Werner,
  • Catherine Pilgrim-Grayson,
  • Lea Berhane,
  • Hana Golding,
  • Patrick Shea,
  • Katherine Fenstermacher,
  • Richard Rothman,
  • Irina Burd,
  • Jeanne Sheffield,
  • Andrea L. Cox,
  • Andrew Pekosz,
  • Sabra L. Klein

摘要

Pregnant women are at heightened risk for severe outcomes from infectious diseases like COVID-19, yet were not included in initial vaccine trials, which may contribute to low booster uptake (15% or lower). We explored the serological and cellular responses to COVID-19 mRNA booster vaccines (i.e., ancestral and BA.5) in pregnant and age-matched, non-pregnant females to identify how pregnancy affects immunity against the vaccine and novel variants. Antibodies from pregnant women were less cross-reactive to non-vaccine antigens, including XBB.1.5 and JN.1. Non-pregnant females showed greater IgG1:IgG3 ratios and neutralization against all variants. In contrast, pregnant women had lower IgG1:IgG3 ratios and neutralization but increased antibody-dependent NK cell cytokine production and neutrophil phagocytosis, especially against novel variants. Pregnancy increased memory CD4+ T cells, IFNγ production, monofunctional dominance, and fatty acid oxidation. Pregnancy may reduce the breadth, composition, and magnitude of humoral and cellular immunity, particularly in response to novel variants.